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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:

40

期数:

2023年2期

页码:

69-73

栏目:

医院管理

出版日期:

2023-02-01

文章信息/Info

Title:

Evaluation of Cost Control Effect of Relevant Medical Reform Policies
——Based on Canceling Drug Price Addition, Canceling Medical Consumable Addition and Diagnosis-Intervention Packet

作者:

黄小红¹; 李云峰²; 杨业春¹

1.广州中医药大学第一附属医院，广东 广州 510405
2.南方医科大学南方医院，广东 广州 510515

Author(s):

HUANG Xiaohong;  LI Yunfeng;  YANG Yechun

The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou Guangdong 510405, China

关键词:

药品零加成; 耗材零加成; 按病种分值付费; 住院费用

Keywords:

canceling drug price addition;  canceling medical consumable addition;  diagnosis-intervention packet;  hospitalization expenses

分类号:

R197

文献标志码:

A

摘要:

目的：分析“药品零加成”“耗材零加成”和“按病种分值付费(DIP)”三项政策对患者住院费用的影响，为完善医改政策和医院管理决策提供参考。方法：选取广州市某三甲医院2015—2020年出院的367 898例患者病案首页数据，采用多重线性回归模型对住院费用进行调整，通过分析住院费用变化趋势及差异，评价政策的控费效果。结果：与医改前“按医疗服务项目付费”相比，“药品零加成”政策使住院总费用和药品费大幅下降，诊疗费明显升高；叠加“DIP”政策后，住院总费用进一步下降；“耗材零加成”政策实施后，耗材费下降明显，但仍高于医改前的平均水平。结论：“药品零加成”和“DIP”政策对控制住院总费用和调整费用结构效果显著；“耗材零加成”政策有助于优化费用结构，但需细化管理策略。

Abstract:

Objective To analyze the changes in the patients' hospitalization expenses after canceling drug and medical consumables addition and paying by disease score (DIP), and to provide references for hospital decision-making and improving medical reform policy. Methods The first page data from the hospital medical records information system of 367898 patients in a first class hospital in Guangzhou from 2015 to 2020 were selected. The changes of hospitalization expenses before and after the implementation of policies were analyzed, where multiple linear regression models were used to control the influence of confounding factors on hospitalization expenses． Results After canceling drug addition, the total hospitalization expenses and drug expenses decreased dramatically and treatment expenses increased significantly, compared with the payment according to medical service items before the reform. Total hospitalization expenses further decreased after adding payment by disease score. After canceling medical consumables addition, material expenses decreased significantly, but it was still higher than the average level before the medical reform. Conclusion Cancellation of drug addition and payment by disease score can effectively reduce the patients' hospitalization expenses and drug expenses and increase treatment expenses reflecting the technical labor of medical staff. The influence of cancellation of medical consumables addition on expenses control was not significant. It is necessary to further strengthen the delicacy management of consumables to reduce medical expenses burden of patients.

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更新日期/Last Update: 2023-02-01